Aim Health Carelon Prior Authorization

Listing Websites about Aim Health Carelon Prior Authorization

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Log In or Register Carelon

(3 days ago) Offered through Carelon Post Acute Solutions (Formerly AIM Specialty Health) Provider portal Submit a new case for prior authorization, or check on an existing one. Access the evidence-based criteria used in our review process. See more

https://www.carelon.com/sign-in-or-register

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Log In or Register Carelon Insights

(1 days ago) WEBMedical Benefits Management: Specialty Care. Provider portal. Submit a new case for prior authorization, or check on an existing one. Clinical guidelines and pathways. Access the evidence-based criteria used in our review process. Log in or register with Carelon Insights, where we rapidly optimize care and costs.

https://www.careloninsights.com/sign-in-or-register

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Carelon Medical Benefits Management (formerly AIM …

(1 days ago) WEBAIM Specialty Health is officially changing its name to Carelon Medical Benefits Management on March 1, 2023. Carelon Medical Benefits Management (formerly AIM) manages prior authorization for select services for Premera Blue Cross. Prior authorization is required for certain procedures and services. Contracted providers are …

https://www.premera.com/wa/provider/utilization-review/carelon-medical-benefits-management/

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Provider Resources Carelon Insights

(Just Now) WEBCall 1-844-411-9622 or contact our support team. For questions about the provider network: Call 1-833-585-6262 or email our network team. Learn more about the provider resources available to help your healthcare organization manage …

https://www.careloninsights.com/provider-resources

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3 – Requests for Authorizations/Retro-authorizations Carelon …

(9 days ago) WEBThe request for retro-authorization must be faxed ( 855-439-2444) to the attention of the Clinical Department or mailed to the attention of: The request for a retro-authorization only guarantees consideration of the request. The provider will receive written notification within thirty (30) calendar days from Carelon’s receipt of the request

https://pa.carelon.com/providers/provider-manual/3-requests-for-authorizationsretro-authorizations/

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Carelon Medical Benefits Management - Horizon BCBSNJ

(3 days ago) WEBCarelon℠ Medical Benefits Management (formerly AIM Specialty Health®) is a specialty benefits management company that supports Horizon by performing Prior Authorization/Medical Necessity Determination (PA/MND) reviews for certain services to be provided to members enrolled in participating self-insured employer group health …

https://www.horizonblue.com/providers/products-programs/utilization-management-programs/carelon-medical-benefits-management

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Carelon Prior Authorization Frequently Asked Questions

(5 days ago) WEBThe ordering provider should contact Carelon the next business day or within 48 hours and ask for an urgent/emergent review. Please note prior authorization is not required if the service is performed in the emergency department. Q If an emergency room physician refers a patient for a diagnostic imaging test at a later date, or to the patient

https://providers.bcidaho.com/resources/pdfs/providers/aim-specialty-health/Carelon-PA-FAQS.pdf

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AIM Specialty Health Changes Its Name to Carelon Medical …

(2 days ago) WEBAIM Specialty Health (AIM) has changed its name to Carelon Medical Benefits Management (Carelon) effective March 1, 2023. Following this change, Blue Cross and Blue Shield of Illinois (BCBSIL) will be making updates on our website to our utilization management page and related resources. Will there be changes to how prior …

https://www.bcbsil.com/provider/education/education-reference/news/2023/03-17-2023

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Carelon Medical Benefits Management (formerly AIM …

(1 days ago) WEBAIM Specialty Health (AIM) manages imaging services for Premera Blue Cross. Providers must make pre-approval requests through AIM for members on plans that require it. To request a prior authorization, register with Carelon and then submit your request online or by phone at 866-666-0776.

https://www.premera.com/ak/provider/utilization-review/carelon-medical-benefits-management/

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Medical Benefits Management Carelon Insights

(9 days ago) WEBLay the foundation forbest-practice care. We keep the member at the center of everything we do. From examining social drivers of health to identifying gaps in care, our solutions are designed to do more than redirect care. …

https://www.careloninsights.com/medical-benefits-management

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Prior Authorization Expansion to AIM - Blue Cross and Blue Shield …

(3 days ago) WEBSubmit prior authorization requests to AIM. when applicable, for Jan. 1, 2021, in one of the following ways: Online – Submit requests via the AIM ProviderPortal 24/7. By Phone – Call the AIM Contact Center at 1-800-859-5299 Monday through Friday, 6 a.m. to 6 p.m., CT; and 9 a,m. to noon, CT on weekends and holidays.

https://www.bcbstx.com/provider/education/education/news/2020-archive/09-28-20-prior-auth-aim

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Procedures that require prior authorization by Carelon

(6 days ago) WEBManagement (formerly AIM Specialty Health ®) This document shows the codes associated with procedures that are managed by Carelon for Blue Cross Blue Shield of Michigan on behalf of Blue Cross and Blue Shield Federal Employee Program Michigan members for services received in Michigan. Submitting prior authorization requests to …

http://ereferrals.bcbsm.com/docs/bcbsm/bcbsm-aim-codes-ppo-fep.pdf

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Carelon Medical Benefits Management (formerly AIM …

(7 days ago) WEBEffective for dates of service on and after June 1, 2023, the following codes will require prior authorization through Carelon Medical Benefits Management, Inc. clinical program. As a reminder, ordering and servicing providers may submit PA requests to Carelon Medical Benefits (AIM Specialty Health) via Availity Essentials* at www.availity.com.

https://providers.anthem.com/docs/gpp/IN_CAID_CarelonCardiologyClinicalProgram.pdf?v=202303222130

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Aim Provider Portal

(4 days ago) WEBReceived more than 1 million prior authorization requests via the ProviderPortal. Introduces OptiNet, the industry’s first web-based diagnostic imaging network management tool, to help health plans manage their imaging provider networks using cost and quality metrics. By integrating AIM’s health system and provider group solution, your

https://www.aimproviderportal.org/

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Changes to Carelon’s (formerly AIM’s) provider portal for …

(8 days ago) WEBOn May 14, 2023, Carelon Medical Benefits Management (formerly AIM Specialty Health®) will release enhancements to the provider portal for the medical oncology program. The goal of the enhancements is to make the process of submitting prior authorization requests easier. Starting May 14, the look and functionality of the clinical intake

https://providerinfo.bcbsm.com/documents/alerts/2023/202303/alert-20230302-pharm-all-aim-portal-webinars.pdf

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Frequently asked questions about Carelon - Blue Cross Blue …

(8 days ago) WEBProcedures that require prior authorization by Carelon: Cardiology, radiology (high technology) and sleep studies (in lab) Michigan’s prior authorization law* requires health care providers to submit prior authorization requests electronically. Alternate submission methods (fax or phone) are allowed in the case of temporary technological

https://ereferrals.bcbsm.com/docs/common/common-aim-faq-nondrugs.pdf

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Carelon to expand existing prior authorization program …

(Just Now) WEBCarelon to expand existing prior authorization program starting Sept. 1. For dates of service on or after Sept. 1, 2023, additional services will require prior authorization by Carelon Medical Benefits Management (formerly known as AIM Specialty Health®). Carelon currently manages select services for Blue Cross Blue Shield of …

https://providerinfo.bcbsm.com/documents/alerts/2023/202306/alert-20230601-carelon-expansion-9-1.pdf

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Resources and tools for providers and health care professionals

(8 days ago) WEBWelcome health care professionals. We invite you to use this website, created especially for health care professionals, to find resources that can help you as you care for your patients. Here you can find our medical policies, stay up to date on the latest news or get training on our many tools and benefit plans.

https://www.uhcprovider.com/

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Home Wellpoint New Jersey, Inc. - Amerigroup

(9 days ago) WEBAmerigroup Community Care in New Jersey is now Wellpoint. Our new name fits with our brand vision to be a source of lasting wellness for our members — your patients — at all points in their health journey. There is no action needed by our care providers. There will be no changes to your agreements or contract, reimbursement, or level of

https://www.provider.wellpoint.com/new-jersey-provider/home

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When ‘Prior Authorization’ Becomes a Medical Roadblock

(5 days ago) WEBStarting in 2026, another new rule will speed the process, cutting the time in which insurers must respond to prior authorization requests to seven days from 14. (For “expedited requests,” it’s 72 hours.) The rule also will require insurance plans to post prior authorization information — numbers of requests, review times, denials and

https://dcsazfdpoc.deloitte.com/when-prior-authorization-becomes-a-medical-roadblock/

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Horizon Behavioral Health

(7 days ago) WEBIf you or a loved one is dealing with daily challenges or serious conditions, Horizon Behavioral Health can help connect you with care, including: Asking for help can be hard, but you’re not alone. Call 1-800-626-2212, 24/7. Certain behavioral health services may require prior authorization. The dedicated Horizon Behavioral Health care team

https://www.horizonblue.com/members/health-programs/horizon-behavioral-health

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Your Care is at Our Core American Medical Association

(9 days ago) WEBWe strive to build trust and provide the most effective care and treatment for our patients each and every day. Through it all, we are honored to support our patients during some of the most vulnerable moments in their lives. Your care is at our core. As physicians, we advocate for what matters most: time to care for and connect with our …

https://www.ama-assn.org/health-care-advocacy/state-advocacy/your-care-our-core

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Gov. Phil Scott signs bill limiting prior authorization, other health

(8 days ago) WEBGov. Phil Scott on Monday evening signed H.766, a bill that takes aim at health insurance company practices such as “prior authorization” and seeks to free health care practitioners from

https://vtdigger.org/2024/05/20/gov-phil-scott-signs-bill-limiting-prior-authorization-other-health-insurer-practices/

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Medicare’s In-Person Visit Requirement Limits Mental Health Care

(9 days ago) WEBTo this aim, investigators conducted a cross-sectional study using de-identified Medicare data from 2018 to 2022 to identify the first telehealth visit for mental health care between patients and

https://www.psychiatryadvisor.com/news/medicare-mental-health-coverage-in-person-visit-requirement/

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DMHC Spring 2024 Newsletter

(4 days ago) WEBThe DMHC protects the health care rights of 29.7 million Californians and ensures a stable health care delivery system. The Department has helped 2.8 million Californians resolve health plan problems through the Help Center. Information and assistance is available at www.DMHC.ca.gov or by calling 1-888-466-2219.

https://dmhc.ca.gov/Resources/Newsroom/Spring2024Newsletter.aspx

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How TEFCA could drive payer-provider interoperability

(3 days ago) WEBPublished: 21 May 2024. Electronic health information exchange (HIE) between healthcare providers has grown in recent years, but interoperability between healthcare providers and payers is lagging. However, the Trusted Exchange Framework and Common Agreement (TEFCA) could help bridge this gap. Born from the 21st …

https://www.techtarget.com/searchHealthIT/feature/How-TEFCA-could-drive-payer-provider-interoperability

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